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A Miniature Baby

Well, despite using a 6’5″ donor and being 5’7″ myself, I somehow birthed a miniature human. She is now 8 months old, and she just weighed in at 11 lb, 2 oz. She’s 25.5″, which is at least ON the growth charts, but only about the 12th percentile for height. Her weight is so far beneath the bottom of the growth charts that it could be estimated as -10%ile, if that even existed. That’s “negative tenth” percentile…

As I’ve written, she came about 5 weeks early, but she was a healthy 6 lb, 6 oz when born. She was not really very interested in eating, so we worked on breastfeeding and bottles in the NICU while she got fortified breast milk through a feeding tube until they deemed her big enough to go home. At home, we breastfed and continued to use some bottles, but she really prefers milk straight from the tap.

For the first six months, our pediatrician took a wait-and-see approach, which was fine with us. I know that the baby had some reflux, and at it’s peak (3-4 months?) she would vomit once or even twice a day, but she would usually recover the milk by re-eating from me. Luckily I have a prolific supply, otherwise those huge throw-ups would have been heartbreaking.

The reflux largely subsided by around 6 months, and we started introducing solids. She has a VERY sensitive gag reflex, so we lost some more food from vomit, but we persevered through trying all kinds of methods of eating (her holding larger items like apple slices, her feeding herself things like peanut butter with a spoon, us using a finger to deliver liquidy sauces, her sucking on the tips of food pouches, us using a spoon to shovel purees, etc.). The most success we’ve had is through spoon/purees, so we’re going with that for now. She has a great palate – she’ll eat almost anything…pesto, mexican food, indian food, fruits, tomato sauce, smoothies, yogurt, etc. (as long as it’s smooth and semi-liquid). She WANTS to eat bigger and chunkier things, but she can’t foresee the guaranteed gag and puke when she tries.

Once we started introducing foods (and I returned to work 100%, up from 75%), her growth seemed to slow even a little bit more. We went in for an 8-month appointment, because we knew weight was not picking up. At this point, the doctor decided we needed additional testing. She ordered blood work and a urine sample. Luckily, we avoided the catheter because the World’s Tiniest Baby has pretty much potty trained herself at 8 months, so all I had to do was catch the pee. I’ll write more about the whole using the toilet thing later. The blood draw was the WORST…holding her down while two nurses attempted to find her tiny vein and she screamed at me to help her.

So far, half the tests have come back normal…no signs of scary things like cystic fibrosis, celiac, liver disease, diabetes, etc. We’re waiting on the other half, but the pediatrician with whom I spoke yesterday (because our normal doctor was not in the office to relay results) seemed equally perplexed. She ordered a fecal sample, so I brought that in this morning. Her only guess was the baby isn’t absorbing something as well as she should (protein? fat?). The only other alternatives are that she’s simply not getting enough calories, or she has an insanely fast metabolism.

As far as calories, she admittedly refuses the bottle of freshly-pumped milk a lot of the time (though this has improved in the last month or so), but she reverse-cycles, meaning she eats a LOT from me when I get home at 3:00 and often eats through the night. She has started getting a few calories from food, but not really enough to matter.

In good news, her head is above 50th percentile, which just makes her look silly. One of our nicknames is “Starving Martian” because she has the skinniest, longest body with a giant head. In other good news, she’s very smart, developmentally average for an adjusted 7-month-old, and very happy. She sits with great confidence, plays with her toys, has excellent fine motor skills, talks and sings (without real words), and has started “scooching” forward in a method similar to crawling with her belly on the ground. She has also had a grand total of one short cold in her entire first 8 months.

I don’t know…on one hand it’s bizarre to have what could be one of the smallest healthy babies on record. On the other hand, I really don’t feel very worried about it. Oddly, I’m more anxious about doctors knowing and believing that we are truly feeding her as much as we can possibly convince her to eat and we’ve tried nearly every method of increasing calories, including adding my own pumped milk fat to my own milk to make it richer. (We’ve also tried adding organic formula powder to my milk…doesn’t seem to make a difference).

The pediatrician referred us to a nutritionist (because she was grasping for any possible idea) and happily obliged when I suggested an occupational therapy referral to figure out how to get her chewing/swallowing in a more functional way. If the nutritionist suggests anything other than using breast milk as the foundation of the baby’s diet, I don’t think I’ll really entertain her.

One other bit of data we have is that I donate my extra milk to an adopted baby boy who was also preemie, and he’s a normal, healthy weight.

So, we press onward and wait for more test results. I’m pretty sick of people saying “oooh, a brand new baby!” whenever we’re in public, but I don’t really mind that she’s still so tiny that I can easily and comfortably carry and snuggle her all the time, haha.

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4 responses

Sometimes they are just small and that is ok as I am sure you are aware of 🙂 Our 5 year old was NEVER on the growth chart for height or weight. He was 3 weeks early but that wasn’t a factor. His doctor ran all of those similar test and they all came back within normal range. Now that he is 5 he is starting to seem the same size as some of his classmates.
We once had a woman who every time she saw him commented “oh he is so small” or “oh he is so tiny” My wife finally got sick of it and said don’t you have anything else to say?? Like he is cute or you like his outfit! Needless to say I am not sure that lady has ever made another comment again.

Ugh how stressful this must be for you (espcially the blood draw!). But I also tend to believe that all babies are so naturally and normally varied and as long as she is otherwise healthy and happy, there’s probably nothing at all to worry about. She is beautiful!
At swimming lessons I’ve really noticed how varied babies can be in size. My girl is 6 months and is the same size as an 11 month old in the class. All shapes and sizes.